seek to control their behavior. Evaluation studies con cluded that these interventions have worked to reduce adolescent smoking by about one-third. Despite the successes of the early years of the 2000s in lowering the rates of cigarette smoking among ado lescents, the rates have now stabilized at over 20%. Evi dence indicates that adolescents who smoke generally do not participate in athletics, more often live in rural areas, and are more often white and less often African American. Males and females smoke about the same amount overall, but white females smoke more and Asian females smoke less than their male counterparts. New drugs taken as pills have recently been shown to increase the rates of success in smoking cessation among adults despite side effects. This is not the situ ation in adolescents because of increased potential for adverse effects, including suicide. A series of interven tions has been suggested for addressing the continu ing problem of adolescent smoking. These include: ☐ Expulsion from school for cigarette smoking Focus on adolescents in tobacco warning labels Selective use of nicotine gum and patches to help with withdrawal M . No smoking rules for sporting events, music con- certs, and other adolescent-oriented events. Fines for adolescents who falsify their age and purchase cigarettes Higher taxes on tobacco products Rewards to students in schools with the lowest smoking rates in a geographic area Higher auto insurance premiums for adolescents. who smoke B - ■ Application of technology to reduce the quantity of nicotine allowed in tobacco products to reduce the potential for addiction Testing of athletes for nicotine and exclusion from competition if they test positive Provision of tobacco counseling as part of medical care covered through insurance The National Academy of Medicine has recom mended that the age for purchase of cigarettes be raised from 18 to 21 years." die Questions ►Smoking and Adolescents- The Continuing Problem The rate of smoking in the United States has been reduced by approximately one-half since the 1960s. However, the rate of smoking among teenagers increased in the 1980s and 1990s, especially among teenage females. This raised concerns that young women would continue smoking during pregnancy. In addition, it was found that nearly 90% of adults who smoked started before the age of 18, and in many cases at a considerably younger age. In the 1980s and most of the 1990s, cigarette smoking was advertised to teenagers and even preteens, or "tweens," through campaigns such as Joe Camel. In recent years, a series of interventions directed at teen- agers and tweens was put into effect. These included. elimination of cigarette vending machines, penalties for those who sell cigarettes to those under 18, and elimina- tion of most cigarette advertising aimed at those under 18. In addition, the Truth' campaign aimed to convince adolescents, who often see smoking as a sign of indepen- dence from their parents, that not smoking is actually a sign of independence from the tobacco companies who